#4428 of 11K

87220

HCPCS Procedure Code

HCPCS code 87220 is the #4,428 most-billed Medicaid procedure code, with $597K in payments across 300K claims from 2018–2024. The national median cost per claim is $2.74.

Total Paid

$597K

0.00% of all spending

Total Claims

300K

Providers

342

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 87220? Based on 316 providers billing this code nationally.

Median

$2.74

Average

$2.93

Std Dev

$4.33

Max

$61.43

Percentile Distribution (Cost per Claim)

p10

$0.15

p25

$1.16

Median

$2.74

p75

$3.76

p90

$4.57

p95

$5.34

p99

$11.47

50% of providers bill between $1.16 and $3.76 per claim for this code.

90% bill between $0.15 and $4.57.

Top 1% bill above $11.47.

About This Procedure

HCPCS code 87220 was billed by 342 providers across 300K claims, totaling $597K in Medicaid payments from 2018–2024. This code was used for 277K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$2.74

Providers Billing

316

National Spending

$597K

Avg/Median Ratio

1.07×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 87220

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1689603748	$52K	$2.12	0.8× median	Below Median
2	1053334755	$50K	$2.33	0.9× median	Below Median
3	1861587321	$38K	$3.13	1.1× median	Above Median
4	Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory	$25K	$2.04	0.7× median	Below Median
5	Unilab Corporation West Hills, CA · Clinical Medical Laboratory	$23K	$1.85	0.7× median	Below Median
6	1457345597	$22K	$7.49	2.7× median	Top 10%
7	University Of Kentucky Lexington, KY · General Acute Care Hospital	$18K	$5.96	2.2× median	Top 10%
8	Children's Health System Of Texas Dallas, TX · General Acute Care Hospital Children	$15K	$61.43	22.4× median	Top 1%
9	1922599117	$13K	$3.97	1.4× median	Above 75th
10	1477692606	$12K	$4.26	1.6× median	Above 75th
11	1477837771	$11K	$3.51	1.3× median	Above Median
12	1215921549	$11K	$2.78	1.0× median	Above Median
13	1003945676	$10K	$2.60	0.9× median	Below Median
14	1356410351	$10K	$5.78	2.1× median	Top 10%
15	1831116441	$9K	$1.08	0.4× median	Below Median
16	Quest Diagnostics Clinical Laboratories Inc Tucker, GA · Clinical Medical Laboratory	$9K	$2.92	1.1× median	Above Median
17	City Of Columbus Columbus, OH · Clinic/Center, Public Health, State or Local	$9K	$2.85	1.0× median	Above Median
18	Quest Diagnostics Llc Il Wood Dale, IL · Clinical Medical Laboratory	$9K	$3.23	1.2× median	Above Median
19	Medical Associates Of Ebnhc East Boston, MA · Clinic/Center, Community Health	$9K	$3.04	1.1× median	Above Median
20	1083644579	$9K	$1.22	0.4× median	Below Median

Showing top 20 of 342 providers billing this code

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